YNHHS goes beyond the microscope with digital pathology

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When patients come to Yale New Haven Hospital for treatment of conditions diagnosed elsewhere, our pathologists must confirm those outside diagnoses.

They also perform consultations for pathologists at other hospitals who want a second opinion on a specimen, need a test that their facility does not perform, or need help with a complex case.

In these situations, the microscope slides containing these samples must be physically sent to YNHH and then returned to the hospital or processing site that collected the samples. This happens thousands of times every year.

“We don’t have a record of these slides because they don’t belong to the hospital,” said John Sinard, MD, PhD, director of anatomical pathology and medical director of pathology informatics at the Yale School. of Medicine (YSM). can be a problem if the patient is ultimately referred to YNHH for treatment.

This is about to change. Yale New Haven Health has begun implementing digital pathology, in which microscope slides containing specimens are scanned to produce digital images that can be viewed and shared electronically. The technology will be tested at YNHH in the coming weeks before being rolled out to other health system delivery networks.

“This is a significant investment that will improve the quality and efficiency of patient care,” said pathologist Sudhir Perincheri, PhD, MBBS, who is leading the effort. “Digital pathology can enable faster diagnoses, which means patient treatment plans can be implemented sooner.”

Digital pathology includes whole-slide imaging (WSI), in which special scanners capture a detailed image of an entire glass microscope slide at magnifications comparable to those of a microscope. So far, YNHHS has purchased two high-volume scanners and software to view and/or analyze digital files. In addition, Yale New Haven’s Clinical Imaging Team and Information Technology Services Department have gone “beyond” to develop systems for storing, labeling and accessing digital files, said Dr. Perincheri. Storage is a particular challenge. Each slide results in a digital file of 300 to 400 megabytes; The pathology department at YNHH produces an average of 1,000 slides per day.

Storage requirements, the development of scanning and reading technology, and the cost of equipment are among the reasons why Pathology has been slow to go digital. But the “significant investment” of funds, time and resources will pay off, said Chen Liu, MD, PhD, chairman and Anthony N. Brady Professor of Pathology at YSM, and chief of pathology YNHH. YNHH will be able to digitize slides it receives from other hospitals for pathology consultations and have an easily accessible record if patients end up here. This will be especially beneficial during Tumor Boards, when physicians from different specialties come together to review patient cases and develop treatment plans.

Additionally, pathologists will be able to examine slides remotely, allowing for timely patient care to continue while enabling safe working conditions and reducing their risk of exposure during situations such as the COVID-19 pandemic. 19.

Once other YNHHS distribution networks convert to digital pathology, clinicians will be able to quickly and easily share samples electronically. This will improve YNHHS’ signature of care, which ensures, in part, that patients receive the same quality of care regardless of their location in the healthcare system, Dr. Liu said.

Other future benefits of digital pathology include strengthening research and opening the door to future advances, such as the use of artificial intelligence to improve diagnostic accuracy.

“That’s the first step,” Dr. Liu said. “We look forward to developing this technology.”

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